Schools consider ways to deal with mental health disorders

Published 11:29 pm, Saturday, March 2, 2013

Janet M. Currie,
Henry Putnam Professor of Economics and Public Affairs
Director of the Center for Health and Well-Being.
Princeton University
Woodrow Wilson School of Public and International Affairs

Janet M. Currie,
Henry Putnam Professor of Economics and Public Affairs
Director of the Center for Health and Well-Being.
Princeton University
Woodrow Wilson School of Public and International Affairs

Photo: Contributed Photo

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Jonathan P. Costa, Sr. is director of school and program services for the EDUCATION CONNECTION, a regional education service center in Litchfield, Connecticut.

Jonathan P. Costa, Sr. is director of school and program services for the EDUCATION CONNECTION, a regional education service center in Litchfield, Connecticut.

Photo: Contributed Photo

Schools consider ways to deal with mental health disorders

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Educators across the state and the country are rethinking, after the Sandy Hook Elementary School massacre, how best to reach the increasing number of children who are struggling with emotional or psychological needs.

The shooter, 20-year-old Adam Lanza, had social integration issues and an uneven school attendance history related to his problems. The morning of Dec. 14, he killed his mother at home, then went to the school and killed 20 first-graders and six adults before killing himself.

In the aftermath of the tragedy, schools are likely to be pushed to help identify and treat students who, like Lanza, showed evidence of mental health problems or socialization issues.

"It's all educators are talking about," said Joyce Emmett, Danbury's retiring director of special services.

"What is our role in identifying youngsters and getting them services?'"

But the notion of asking educators to shoulder this burden alarms many experts, and even those who support stronger treatment and counseling programs say it would require a major increase in training and funding.

Whether the state and country actually have the will and commitment to spend more is a concern.

Experts say the approach must be multi-faceted -- new gun laws, education for parents about mental health issues, collaborations between schools and community mental health services, and more training for staff. "It's a real wake-up call. It's so close to home and the age of the children who were killed was startling," Emmett said.

Prevention is key

Although the tragedy has added impetus, efforts toward intervention have been in the works for years. But more are needed, experts say.

The Connecticut Department of Education in recent years has instituted a couple of programs -- Scientific Research-Based Interventions and Positive Behavioral Intervention and Supports -- to provide schools a uniform system to identify and intervene early with children who have special needs and to provide guidance on implementing behavior remedies.

"There are a number of beefed-up, overlapping approaches, but there needs to be the availability of services for students that can be held harmless (not be cut) in the budget process," said Jonathan Costa, director of the School and Program Services for the western Connecticut regional education support group Education Connection.

"Prevention is incredibly less expensive than the cure. If you get behind on a problem, you'll spend more to correct it than if you stay ahead," Costa said.

"We have seen that districts are trying to do their best to keep their students at home, but the depth of the issues is so great that it is very difficult for a school district to help some of these kids."

Districts already are working on changes even as Gov. Dannel P. Malloy's commission on Sandy Hook looks at mental health services available in schools and communities with the charge of recommending what else is needed.

"We'll be looking to add resources to make sure our children are emotionally available to learn," Emmett said.

"There is a community-based counseling program that is helpful for kids and families that is being looked at to pilot in a few schools.

"It was in the works before the tragedy in Newtown, and now it's getting more attention."

Parents need clarity

Evan Pitkoff, a former special education teacher and Newtown superintendent from 2002 to 2007, during Lanza's schooling, is executive director of the Cooperative Educational Services, which serves as a resource to 16 school districts in lower Fairfield County.

"There will need to be more professional development for all staff to help them better identify early signs of emotional problems and then for making recommendations," he said.

While Pitkoff would not speak about Lanza, he noted that Lanza was removed from school and acted after he left the system.

"As a school system, we have mechanisms to identify, treat or to refer out students, but that requires the cooperation of parents," Pitkoff said.

"Teachers are trained to see many early signs of problems, and there are remedies in place, but school is only one aspect of a child's life."

Emmett agreed.

"When we do identify youngsters who are having problems, it requires helping parents to see the same problems that educators see. Parents often feel guilty that their children have problems," she said.

"One issue is helping parents acknowledge small problems so the school and parents can team up to provide help."

Mental health problems rise

The number of children with mental health disorders is increasing at an astonishing rate, as noted in the "Future of Children" Spring 2012 issue.

"The measured prevalence of disability for children under age 18 in the National Health Interview Surveys doubled from 3.8 percent in 1981 to 8 percent in 2009," wrote author and Princeton professor Janet M. Currie and author Robert Kahn in their introduction.

"In 2008--09, the top five limiting conditions of children were behavioral or developmental," the authors said.

But while the disabilities have been shifting from physical to mental health, services have not adjusted accordingly, they said.

"One indication of the severity of the problem is that even as mental disabilities make up a growing share of children's disabilities, a disproportionate share of services for the disabled is still targeted at physical disabilities.

The Future of Children survey also stated, "Likewise, systems set up to deal with medical problems such as clinics for children with disabilities, or public insurance programs, are not coordinated with services at schools."

In a telephone interview, Currie said she thinks the most urgent task in the aftermath of the Newtown shootings is to develop a greater coordination between schools districts and medical professionals.

While privacy concerns are used as the reason for the lack of coordination, Currie said, that does not serve the students.

"It's not clear how you can help people if you don't know what they have," she said.

Currie said it will be very difficult for schools to address the medical and mental health issues of children without bigger budgets.

"Personally, I think gun control would have more effect than reforming school services," she said.

"There are many, many students who are growing up with mental health issues that are not being addressed by the schools, and they will continue to have problems that will not be addressed as they become adults," Currie said.

"We shouldn't only care about the mental health issues of students after this kind of tragedy. We should always care about them getting the services they need."

Schools reflect social stresses

Stamford schools are rethinking their services in the aftermath of Newtown, but the district already had begun to make changes raised in the report.

For instance, it hired an additional social worker who will be the point person for a student going from a hospital or incarceration back to school.

"We want to be able to communicate with our health services providers outside of school -- with parent permission, of course," said Mike Meyer, director of special services and director of the office for community and family engagement for the Stamford schools.

Stamford's superintendent has added $500,000 to her budget for school safety and to increase supports for behavioral health issues in the district, Meyer said. His staff reports an increase in students who are hospitalized for psychiatric problems.

The district plans to educate all the groups in the school, from staff to students, about how they can help struggling students get the help they need.

Families, too, will be taught about available community services.

In the Greenwich public school district, there is a full complement of mental health support staff, including Spanish-speaking psychologists, according to Mary Forde, director of pupil personnel services.

"We have the mental health support we need," Forde said, as well as staff trained in behavior supports and how to teach social skills.

She emphasized that a discussion of violence must be kept separate from that of special needs, but said the Newtown tragedy can offer an important spotlight on schools.

"As with other large, horrific events, there is always a reaction. Hopefully, people will look at what they are doing, and it can spark a conversation," she said, "whether it's having a larger class size so you can hire more medical staff, or other things."

The talks must focus on what is in the best interest of kids, she said.

The shootings in Newtown has definitely has raised awareness of the need for mental health services in schools, Costa said.

"We have seen problems become more complex, more challenging to deal with," he said.

"Schools are always a reflection of the society they serve.

"As more of society has increased stress, as economic resources are stressed, the pressures reach down to the most vulnerable, and children are the most vulnerable."